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IntroductionThe Strengths and Difficulties Questionnaire (SDQ) is one of the most widely used screening instruments in child and adolescent psychiatry. Studies have shown that the parent is a better informant than the adolescent, both for externalising and internalising disorders (Goodman et al, 1997, 2000).ObjectivesAim of this study was to examine the prevalence of parent and adolescent reported internalising problems in outpatient child and adolescent psychiatry setting using SDQ and examine the differences between parent and adolescent reports.MethodsThe study group was 101 adolescents (11-17 y.o.) and their parents, in 2 outpatient psychiatric care centres in Latvia. Internalising problems were assessed using SDQ parent and self-report version. When analyzing the score, 3rd and 4th band were defined as “high”.ResultsThe mean age of adolescent population was 14,04 years (SD 1,96) and N=54 were female. 60,4% of parents and 52,5% of adolescents reported high level of peer problems, 63,4% of parents and 51,5% of adolescents reported high level of emotional problems. Parent and adolescent report results were concordant in two thirds of cases. Adolescents reported high emotional and peer problems in 9% and 14% of cases respectively, when their parents did not. And on the contrary - 22% of parents reported high level of internalising problems when the adolescent did not.ConclusionsMore than half of reports showed high levels of internalising problems. Every fifth parent reported a higher level of internalising problems than their adolescent. This agrees with previous findings that single informant (parent) reports might be more informative than multi-informant reports.

Introduction Screening instruments can be crucial in child and adolescent mental healthcare practice by allowing to triage the patient flow in a limited resource setting and help in clinical decision making. However, for a screening procedure to work, we must be sure that the screening tools used have reasonable validity and clinical utility in the population they are used in. Objectives Our study aimed to examine the psychometric and predictive properties of the parent-report version of the Strengths and Difficulties Questionnaire (SDQ), with the application of the original UK-based scoring algorithm, in a clinical psychiatric population sample of Latvian children and adolescents. Methods 363 outpatients aged 2 to 17 years from two outpatient child psychiatry centres in Latvia were screened with the parent-report version of the SDQ and assigned clinical psychiatric diagnoses. The basic psychometric properties, and ability of the SDQ to predict the clinical diagnosis in major diagnostic groups (emotional, conduct, hyperactivity, and developmental disorders) was assessed. Results Most of the study participants were male (n=230, 63%). The mean age was 9,28 (SD=3,82) years for males and 10,93 (SD=4,11) years for females. Emotional problems, hyperactivity, and prosocial subscales of the SDQ, as well as the externalising and total difficulties scales, demonstrated acceptable internal consistency (Cronbach’s alfa > 0,7). The results for the conduct problems and internalising difficulties scales were also close to being on the acceptable level (0,68 and 0,69 respectively). The peer problems subscale was the only SDQ scale with poor internal consistency (0,57). The subscales of the parent-report SDQ showed significant correlation with the corresponding clinical diagnoses. The sensitivity and specificity of appropriate subscales of the parent-report SDQ were 67% CI [0,57,0,77] and 57% CI [0,50, 0,64] for any emotional disorder, 78% CI [0,67, 0,89] and 57% CI [0,50, 0,64] for any conduct disorder, 65% CI [0,55, 0,75] and 78% CI [0,73, 0,83] for the hyperkinetic disorder, 72% CI [0,63, 0,81] and 44% CI [0,36, 0,52] for developmental disability. Overall, none of the subscales of the SDQ has reached the interval of potential usefulness for clinical decision-making in specialized psychiatric settings, based on the positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio estimates. Conclusions We suggest the SDQ rather be used in primary healthcare settings, where it can be an essential tool to help family physicians recognise children needing further specialised psychiatric evaluation. There is a need to assess the psychometric properties and validate the SDQ in a larger populational sample in Latvia, determine the population-specific cut-off scores, and reassess the performance of the scale in primary healthcare practice. Disclosure of Interest None Declared

Background and Objectives: Intraoperative bleeding during neurosurgical procedures poses a significant risk by increasing morbidity and mortality, obscuring the surgical field and prolonging operative time and hospitalization. Effective hemostasis is therefore essential, frequently necessitating the use of topical hemostatic agents. This study aimed to evaluate the performance of a plant-derived oxidized regenerated cellulose (ORC) hemostatic agent StypCel™ Absorbable Hemostat (Medprin Regenerative Medical Technologies Co., Ltd.) in various neurosurgical interventions, including intracranial tumor resections, spinal surgeries, trigeminal neuralgia operations, cerebrospinal fluid fistula repair and ventriculoperitoneal shunt implantation. The study aimed to assess its performance in these procedures due to the high risk of intraoperative bleeding and the challenges of achieving hemostasis in delicate neural structures. Materials and Methods: This prospective, single-arm clinical study included 46 patients who underwent neurosurgical procedures at three neurosurgerical clinics in Riga, Latvia. The primary endpoint was the rate of effective bleeding control achieved within 5 min of StypCel™ application. Safety assessments included monitoring for central nervous system infections (CNSI), intracranial granuloma formation, new-onset neurological deficits, seizures, anaphylactic reactions or device malfunction. All adverse events (AEs) and serious adverse events (SAEs) were documented during the postoperative follow-up. Results: The cohort consisted of 46 patients (29 females and 17 males), including 20 with neoplastic intracranial lesions and 26 with other neurosurgical pathologies. Effective bleeding control within 5 min was achieved in 93.5% of cases (95% CI: 82.1–98.6%). In three patients, bleeding control exceeded 5 min due to unexpected arterial hemorrhage encountered during intracranial tumor resection. No device-related AEs, SAEs, CNSIs or granuloma formations were reported throughout the follow-up period. Conclusions: The findings demonstrate that StypCel™ Absorbable Hemostat is a safe and effective adjunct for achieving intraoperative hemostasis in neurosurgical procedures. Its favorable safety profile and high hemostatic success rate support its clinical utility, particularly for controlling low-pressure venous or capillary bleeding. Further comparative and long-term studies are warranted to validate these results in broader surgical settings.

Background and Objectives: In recent years, electronic scooters (e-scooters) have gained popularity, whether for private use or as a publicly available transportation method. With the introduction of these vehicles, reports of e-scooter-related accidents have surged, sparking public debate and concern. The aim of this study was to analyze the epidemiological data, characteristics, and severity of traumatic brain injury (TBI) related to e-scooter accidents. Materials and Methods: This retrospective case series evaluated patients who were admitted to the three largest neurosurgery clinics in Riga, Latvia, from the time period of April to October in two separate years—2022 and 2023—after e-scooter-related accidents. The data were collected on patient demographics, the time of the accident, alcohol consumption, helmet use, the type of TBI, other related injuries, and the treatment and assessment at discharge. Results: A total of 28 patients were admitted with TBI related to e-scooter use, with a median age of 30 years (Q1–Q3, 20.25–37.25), four individuals under the age of 18, and the majority (64%) being male. In 23 cases, the injury mechanism was falling, in 5 cases, collision. None were wearing a helmet at the time of the injury. Alcohol intoxication was evident in over half of the patients (51.5%), with severe intoxication (>1.2 g/L) in 75% of cases among them. Neurological symptoms upon admission were noted in 50% of cases. All patients had intracranial trauma: 50% had brain contusions, 43% traumatic subdural hematoma, and almost 30% epidural hematoma. Craniofacial fractures were evident in 71% of cases, and there were fractures in other parts of body in three patients. Six patients required emergency neurosurgical intervention. Neurological complications were noted in two patients; one patient died. Conclusions: e-scooter-related accidents result in a significant number of brain and other associated injuries, with notable frequency linked to alcohol influence and a lack of helmet use. Prevention campaigns to raise the awareness of potential risks and the implementation of more strict regulations should be conducted.

Background and Objectives: Intraoperative bleeding during neurosurgical procedures poses a significant risk by increasing morbidity and mortality, obscuring the surgical field and prolonging operative time and hospitalization. Effective hemostasis is therefore essential, frequently necessitating the use of topical hemostatic agents. This study aimed to evaluate the performance of a plant-derived oxidized regenerated cellulose (ORC) hemostatic agent StypCel™ Absorbable Hemostat (Medprin Regenerative Medical Technologies Co., Ltd.) in various neurosurgical interventions, including intracranial tumor resections, spinal surgeries, trigeminal neuralgia operations, cerebrospinal fluid fistula repair and ventriculoperitoneal shunt implantation. The study aimed to assess its performance in these procedures due to the high risk of intraoperative bleeding and the challenges of achieving hemostasis in delicate neural structures. Materials and Methods: This prospective, single-arm clinical study included 46 patients who underwent neurosurgical procedures at three neurosurgerical clinics in Riga, Latvia. The primary endpoint was the rate of effective bleeding control achieved within 5 min of StypCel™ application. Safety assessments included monitoring for central nervous system infections (CNSI), intracranial granuloma formation, new-onset neurological deficits, seizures, anaphylactic reactions or device malfunction. All adverse events (AEs) and serious adverse events (SAEs) were documented during the postoperative follow-up. Results: The cohort consisted of 46 patients (29 females and 17 males), including 20 with neoplastic intracranial lesions and 26 with other neurosurgical pathologies. Effective bleeding control within 5 min was achieved in 93.5% of cases (95% CI: 82.1–98.6%). In three patients, bleeding control exceeded 5 min due to unexpected arterial hemorrhage encountered during intracranial tumor resection. No device-related AEs, SAEs, CNSIs or granuloma formations were reported throughout the follow-up period. Conclusions: The findings demonstrate that StypCel™ Absorbable Hemostat is a safe and effective adjunct for achieving intraoperative hemostasis in neurosurgical procedures. Its favorable safety profile and high hemostatic success rate support its clinical utility, particularly for controlling low-pressure venous or capillary bleeding. Further comparative and long-term studies are warranted to validate these results in broader surgical settings.

Intraoperative bleeding during neurosurgical procedures poses a significant risk by increasing morbidity and mortality, obscuring the surgical field and prolonging operative time and hospitalization. Effective hemostasis is therefore essential, frequently necessitating the use of topical hemostatic agents. This study aimed to evaluate the performance of a plant-derived oxidized regenerated cellulose (ORC) hemostatic agent StypCel™ Absorbable Hemostat (Medprin Regenerative Medical Technologies Co., Ltd.) in various neurosurgical interventions, including intracranial tumor resections, spinal surgeries, trigeminal neuralgia operations, cerebrospinal fluid fistula repair and ventriculoperitoneal shunt implantation. The study aimed to assess its performance in these procedures due to the high risk of intraoperative bleeding and the challenges of achieving hemostasis in delicate neural structures. This prospective, single-arm clinical study included 46 patients who underwent neurosurgical procedures at three neurosurgerical clinics in Riga, Latvia. The primary endpoint was the rate of effective bleeding control achieved within 5 min of StypCel™ application. Safety assessments included monitoring for central nervous system infections (CNSI), intracranial granuloma formation, new-onset neurological deficits, seizures, anaphylactic reactions or device malfunction. All adverse events (AEs) and serious adverse events (SAEs) were documented during the postoperative follow-up. The cohort consisted of 46 patients (29 females and 17 males), including 20 with neoplastic intracranial lesions and 26 with other neurosurgical pathologies. Effective bleeding control within 5 min was achieved in 93.5% of cases (95% CI: 82.1-98.6%). In three patients, bleeding control exceeded 5 min due to unexpected arterial hemorrhage encountered during intracranial tumor resection. No device-related AEs, SAEs, CNSIs or granuloma formations were reported throughout the follow-up period. The findings demonstrate that StypCel™ Absorbable Hemostat is a safe and effective adjunct for achieving intraoperative hemostasis in neurosurgical procedures. Its favorable safety profile and high hemostatic success rate support its clinical utility, particularly for controlling low-pressure venous or capillary bleeding. Further comparative and long-term studies are warranted to validate these results in broader surgical settings.

Background and Objectives: COVID-19 disease, caused by the SARS-CoV-2 virus, has presented significant challenges to global health, with acute and chronic implications for various aspects of well-being, including sleep and quality of life. This study aimed to investigate the impact of SARS-CoV-2 infection on sleep quality, daytime sleepiness, and quality of life in hospitalised and home-treated patients after three and six months. Materials and Methods: A longitudinal cohort study was conducted, enrolling hospitalised patients from a single clinical university hospital and home-treated participants through a survey spread through social networks. Individuals who had tested positive for the SARS-CoV-2 virus in the past three months and had a symptomatic course of the disease were included in the study. Participants with previously diagnosed sleep disorders were excluded from the study. Participants were evaluated using internationally validated self-evaluation scales, including the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9) and Fatigue Severity Scale (FSS). Data were collected three and six months after laboratory-confirmed SARS-CoV-2 infection, with informed consent obtained from all participants. Statistical analysis was performed using the Wilcoxon signed rank test, Fisher–Freeman–Halton exact, Pearson Chi tests and Spearman correlation. Results were considered statistically significant with p value < 0.05. Results: In total, 66 participants with a mean age of 44.05 ± 21.61 years were enrolled in the study. Most patients (n = 36) were treated at home and 30 at hospital. Six months after SARS-CoV-2 infection, home-treated patients reported a higher prevalence of poor sleep quality (52.8%, n = 19, p = 0.015, PSQI) and hospitalised patients showed a lower prevalence of depressive symptoms (p < 0.001, PHQ-9) as 90% (n = 27) had minimal or no symptoms compared to 30.6% (n = 11) in a home-treated group. Conclusions: These findings mark the importance of the COVID-19 patients’ management settings as people treated at home had worse sleep quality and more depressive symptoms six months after infection indicating worse life quality.

Background and Objectives: Screening instruments can be crucial in child and adolescent mental healthcare practice by allowing professionals to triage the patient flow in a limited resource setting and help in clinical decision making. Our study aimed to examine whether the Strengths and Difficulties Questionnaire (SDQ), with the application of the original UK-based scoring algorithm, can reliably detect children and adolescents with different mental disorders in a clinical population sample. Materials and Methods: a total of 363 outpatients aged 2 to 17 years from two outpatient child psychiatry centres in Latvia were screened with the parent-report version of the SDQ and assigned clinical psychiatric diagnoses. The ability of the SDQ to predict the clinical diagnosis in major diagnostic groups (emotional, conduct, hyperactivity, and developmental disorders) was assessed. Results: The subscales of the parent-report SDQ showed a significant correlation with the corresponding clinical diagnoses. The sensitivity of the SDQ ranged 65–78%, and the specificity was 57–78%. The discriminative ability of the SDQ, as measured by the diagnostic odds ratio, did not quite reach the level of clinical utility in specialised psychiatric settings. Conclusions: We suggest the SDQ be used in primary healthcare settings, where it can be an essential tool to help family physicians recognise children needing further specialised psychiatric evaluation. There is a need to assess the psychometric properties and validate the SDQ in a larger populational sample in Latvia, determine the population-specific cut-off scores, and reassess the performance of the scale in primary healthcare practice.